Diagnosis and treatment of hypertension in elderly

Abstract

Introduction: Arterial hypertension (AHT)is the most common cause of morbidity and mortality in developed societies. Recent data assessed the current prevalence of arterial hypertension in the world around 30 %. Materials and Methods: According to the working hypothesis and proposed tasks we approached closely the procedure of selecting patients on which we would focus our exploration, examining a sample of 150 patients diagnosed with hypertension. The assessment was based on questionnaires previously developed under the general and special methods of clinical examination. For each patient selected was completed an original questionnaire that included: general data, historical data, clinical data, laboratory and instrumental examinations performed and supportive treatment. So we followed the following inclusion criteria: certain diagnosis of hypertension and age>65 years. Results: We found that patients with predominant isolated systolic arterial hypertension was - 36,66 %. The ratio of male / female predominance certified women in the study group - 59.33%. One of the most important criteria that was statistically evaluated is the classification of patients after BP values. The results show that in the study group predominates isolated systolic hypertension - 36,66%, AHT III - 28.66%, AHT gr. II - 32%, AHT gr. I - 2.6%. Laboratory evaluation found that the most common ECG abnormalities encountered in elderly patients with AHT are HVS (38 %), atrial fibrillation (26%) and reduced FE by echocardiography detect 18.66 % cases. From antihypertensive drugs in elderly with arterial hypertension are commonly used diuretics: loop (71.33 %), thiazide - like (26,66 %) and aldosterone (24%), angiotensin-converting enzyme inhibitors (83.33 %) and the calcium channels blockers (56 %). Analyzing the treatment of the patient we found that most patients receive combination treatment of 3 antihypertensive drugs 39,33% (59 patients), the combination of two antihypertensives was noted in 33,33% (50 patients), the combination of four drugs have been reported in 37 patients and administration of a single drug has been found in 4 patients in the study group. Conclusions: Hypertension is a major risk factor for cardiovascular morbidity and mortality, particularly in elderly, so the correct treatment reduces death rates and rates of CV effects related to people over 65 and people aged over 80 years, the treatment does not appear to significantly reduce the overall rates of death, but decreases the risk of heart disease.